Gut infection

Once again the defence mechanisms that keep foreign chemicals at bay have succeeded. However, this can be turned around and used to therapeutic advantage. For example, if an aminoglycoside antibiotic is very poorly absorbed from the gut, a large proportion of any oral dose will remain there and may be useful for treating gut infections. 

Clindamycin is indicated for the treatment of skin and soft-tissue infections caused by streptococci and staphylococci. It is often active against community-acquired strains of methicillin-resistant S aureus, an increasingly common cause of skin and soft tissue infections. Clindamycin is also indicated for treatment of anaerobic infection caused by bacteroides and other anaerobes that often participate in mixed infections. Clindamycin, sometimes in combination with an aminoglycoside or cephalosporin, is used to treat penetrating wounds of the abdomen and the gut infections originating in the female genital tract, eg, septic abortion and pelvic abscesses and aspiration pneumonia. Clindamycin is now recommended rather than erythromycin for prophylaxis of endocarditis in patients with valvular heart disease who are undergoing certain dental procedures. Clindamycin plus primaquine is an effective alternative to trimethoprim-sulfamethoxazole for moderate to moderately severe Pneumocystis jiroveci pneumonia in AIDS patients. It is also used in combination with pyrimethamine for AIDS-related toxoplasmosis of the brain. 

Clindamycin is indicated for treatment of severe anaerobic infection caused by bacteroides and other anaerobes that often participate in mixed infections. Clindamycin, sometimes in combination with an aminoglycoside or cephalosporin, is used to treat penetrating wounds of the abdomen and the gut infections originating in the female genital tract, eg, septic abortion and pelvic abscesses or... 

Colitis may result from various gut infections, especially amoebic colitis. Clindamycin, vancon cin or metronidazole may be used in treatment. The diarrhoea of colitis states may be treated with normal ANTIDIARRHOEALS, e.g. the opioids codeine, morphine, diphenoxylate and loperamide. The colic may respond to ANTISPASMODICS, e.g. the anticholinergics atropine, hyoscine, dicyclomine, propantheline. Meheverine is a direct-acting antispasmodic effective in some types of gut colic. 

Bicillin benzathin penicillin, bicozamycin [inn] is a diketopiperazine antibiotic. It can be used as an ANTIBACTERIAL antiinfective agent for gut infections, and commercially as a growth stimulant for chickens and swine. 

Cinoiazepam [inn] is one of the [1,41 benzodiazepines, a BENZODIAZEPINE BINDING-SITE AGONIST, with most of its properties similar to diazepam. It has HYPNOTIC, ANTICONVULSANT and ANXIOLYTIC activity. It has been used orally to treat insomnia and anxiety, cinoxacin [ban, inn, jan, usan] (Clnobac ) is an ANTIMICROBIAL, One of a 4-quinolone family related to nalidixic acid, which, though symthetic, are sometimes described as ANTIBIOTICS. It can be used clinically as an ANTIBACTERIAL, mainly used orally for gut infections. Cinoxate [inn, usan] is a cinnamic acid derivative and can be used in topical sunscreen preparations. 

It is not known how important this interaction is likely to be in practice, but the efficacy of colistin in gut decontamination and gut infections may be decreased. Separating the dosages might not be effective in some postoperative patients because their gastric function may not return to normal for up to 5 days, and some sucralfate might still be present when the next dose is given. More study is needed to find out whether this interaction is clinically important, but in the meanwhile it would seem prudent to monitor concurrent use carefully, being alert for any evidence of reduced effects. 

RA could regulate activation of T cells, B cells, and DCs differentiation of T cells and B cells and production of immunoglobulin and T cell homing to gut. These immunological functions of RA might contribute to human immunity, including preventing gut infection. 

UTI, GUT, skin infections, upper and lower RTI, and GI tract infection... 

Fattovich G, Giustina G, Christensen E, Pantalena M, Zagni I, Realdi G, Schalm SW (2000) Influence of hepatitis delta virus infection on morbidity and mortahty in compensated cirrhosis type B. Gut 46 420 26... 

Picomaviruses Poliovirus Naked icosahedral particles 28 nm in diameter One of a group of enteroviruses common in the gut of humans. The primary site of multiplication is the lymphoid tissue of the alimentary tract. Only rarely do they cause systemic infections or serious neurological conditions like encephalitis or poliomyelitis... 

The gut is vulnerable to infection by vimses, bacteria, parasites and occasionally fungi. Vims infechons are the most prevalent but are not suscephble to chemotherapeutic intervenhon. Bacterial infections are more readily recognized and raise questions eonceming the role of antibiohc management. Parasitic infechons of the gut are beyond the scope of this chapter. 

It has the ability to cross the placenta and therefore provides a major line of defence against infection for the newborn. This can be reinforced by transfer ofcolostral IgG across the gut mucosa of the neonate. It diffuses readily into the extravascular spaces where it can act in the neutralization of bacterial toxins and can bind to microorganisms enhancing the process of phagocytosis (opsonization). This is due to the presence on the phagocytic cell surface of a receptor for Fc. 

Two major advantages stem from the use of live vaccines. Firstly, the immunization mimics a natural infection such that only a single exposure is required to render an individual immune. Secondly, the exposure may be mediated through the natural route of infection (e.g. oral) thereby stimulating an immime response that is appropriate to a particular disease (e.g. secretory antibody as primary defence against poliomyelitis virus in the gut). 

Davies, G.R., Simmonds, N.J., Stevens, T.R.J., Grandison, A. and Rampton, D.S. (1991). Enhanced production of reactive oxygen species by gastric mucosa infected with Helicobacter pyirri. Gut 32, A564. 

Sobala, G.M., Crabtree, J., Dixon, M.F., Schorah, C.J., Taylor, J.D., Rathbone, B.J., Heatley, R.V. and Axon, A.T.R. (1991a). Acute Helicobacter pylori infection clinical features, local and systemic immune response, gastric mucosal histology and gastric juice ascorbic acid concentrations. Gut 32, 1415-1418. 

Low-dose dopamine is not without adverse reactions and most studies have failed to evaluate its potential toxicities. Adverse reactions that may be associated with low-dose dopamine include tachycardia, arrhythmias, myocardial ischemia, depressed respiratory drive, and gut ischemia. Low-dose dopamine has also been postulated to impair resistance to infection through a reduction in prolactin concentrations.21 Furthermore, significant overlap in receptor activation occurs. Therefore, doses considered to activate only dopamine receptors may increase cardiac output and blood pressure through dopamine s effect on 3- or a-adrenergic receptors. 

Shigella strains invade intestinal epithelial cells with subsequent multiplication, inflammation, and destruction.8 The organism infects the superficial layer of the gut, rarely penetrates beyond the mucosa, and seldom invades the bloodstream. However, bacteremia can occur in malnourished children and I immunocompromised patients. 

Parenteral nutrition can be a lifesaving therapy in patients with intestinal failure, but the oral or enteral route is preferred when providing nutrition support ( when the gut works, use it ). Compared with PN, enteral nutrition generally is associated with fewer infectious complications (e.g., pneumonia, intraabdominal abscess, and catheter-related infections) and potentially improved outcomes.1-3 However, if used in appropriate patients (i.e., patients with questionable intestinal function or when the intestine cannot be used), PN can be used safely and effectively and may improve nutrient delivery.4 Indications for PN are listed in Table 97-1.1... 

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